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Influence of the presence of tissue expanders on energy deposition for post-mastectomy radiotherapy.
Trombetta, Débora M; Cardoso, Simone C; Facure, Alessandro; da Silva, Ademir X; da Rosa, Luiz Antonio R.
Afiliação
  • Trombetta DM; Programa de Engenharia Nuclear/Instituto Alberto Luiz Coimbra de Pós-graduação e Pesquisa de Engenharia (COPPE) - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
PLoS One ; 8(2): e55430, 2013.
Article em En | MEDLINE | ID: mdl-23405149
An increasing number of studies have shown that post-mastectomy radiotherapy presents benefits associated with the patients survival and a significant fraction of the treated patients makes use of tissue expanders for breast reconstruction. Some models of tissue expanders have a magnetic disk on their surface that constitutes heterogeneity in the radiation field, which can affect the dose distribution during the radiotherapy treatment. In this study, the influence of a metallic heterogeneity positioned in a breast tissue expander was evaluated by means of Monte Carlo simulations using the MCNPX code and using Eclipse treatment planning system. Deposited energy values were calculated in structures which have clinical importance for the treatment. Additionally, the effect in the absorbed energy due to backscattering and attenuation of the incident beam caused by the heterogeneity, as well as due to the expansion of the prosthesis, was evaluated in target structures for a 6 MV photon beam by simulations. The dose distributions for a breast treatment were calculated using a convolution/superposition algorithm from the Eclipse treatment planning system. When compared with the smallest breast expander volume, underdosage of 7% was found for the largest volume of breast implant, in the case of frontal irradiation of the chest wall, by Monte Carlo simulations. No significant changes were found in dose distributions for the presence of the heterogeneity during the treatment planning of irradiation with an opposed pair of beams. Even considering the limitation of the treatment planning system, the results obtained with its use confirm those ones found by Monte Carlo simulations for a tangent beam irradiation. The presence of a heterogeneity didn't alters the dose distributions on treatment structures. The underdosage of 7% observed with Monte Carlo simulations were found for irradiation at 0°, not used frequently in a clinical routine.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Planejamento da Radioterapia Assistida por Computador / Neoplasias da Mama / Dispositivos para Expansão de Tecidos / Mastectomia Tipo de estudo: Health_economic_evaluation Limite: Female / Humans Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Planejamento da Radioterapia Assistida por Computador / Neoplasias da Mama / Dispositivos para Expansão de Tecidos / Mastectomia Tipo de estudo: Health_economic_evaluation Limite: Female / Humans Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos